Tragedies emphasize need for mental health reform

Columbine. Aurora. Newtown. Charleston. And most recently, Umpqua. These places have become synonymous with the mass murders of innocent people. With each act, questions emerge about access to guns and the perpetrator’s mental health. I am setting aside discussion surrounding the weapons involved and the pros and cons of gun control, so as to examine a subject about which I know considerably more: mental illness and the inadequately funded system attempting to treat the disease.

As a behavioral health care provider, our organization must pinch pennies and be highly innovative just to be able to deliver care to the more than 23,000 people we serve each year in south Alabama. The complexity of severe mental illness and the stigma related to both the diagnoses and the treatment create barriers to understanding the need for more funding and reforming the mental health system in the United States.

When a mass killing occurs, both the media and society usually try to explain the atrocity without waiting for the answer to “Is the shooter mentally ill?” Instead, they proclaim that the “shooter” must be mentally ill. After all, how could a sane individual commit such a dreadful act? More times than not, the unfortunate truth is that the perpetrator often has undiagnosed or untreated mental illness. Yet each case is multifaceted, and the details do not readily point to ways the criminal acts could have been prevented.

The questions begging to be asked should be, “What do we know?” and “What can be done?” about the societal dilemma related to mental illness and prevention of these crimes.

For starters, we know that people diagnosed with mental illness perpetrated fewer than 5 percent of the 120,000 gun-related killings in the United States between 2001 and 2010. We also know the mentally ill are 60 to 120 percent more likely than the average person to be the victims rather than the perpetrators of violent crime. These statistics are found in a study conducted by two Vanderbilt University professors that was published in the American Journal of Public Health.

Second, it is a fact that the stigma of mental illness keeps people away from treatment. We could reduce this stigma by educating more people about the disease.

Third, it is common knowledge among behavioral health care providers that with appropriate diagnosis, treatment and compliance with prescribed medications, most people with mental illness can achieve recovery. We need to find ways to help people needing mental health care to seek it.

Last, we know that a greater investment of federal, state and local money to fund mental health services and psychiatric medical education is needed. Likewise, implementation and enforcement of more equitable and reasonable commitment laws could help thousands of individuals receive treatment and stay out of courts and jails.

Action must be taken to increase mental health education, which will decrease stigma; improve behavioral healthcare services and their provision, which will help more individuals achieve recovery; and evaluate and implement more effective laws, which will reduce the numbers of people that are incarcerated and increase the numbers receiving treatment.

The depressing reality is that action often is not taken at any level of government until after a mass murder, the flurry of media coverage, and the unbearable “moments of silence” observed on the floors of Congress. The difference now is that there seems to be urgency in those hallowed halls to find solutions.

If just one of the proposed bills described below becomes law, society in general and, specifically, people living with severe mental illness would benefit greatly:

The Helping Families in Mental Health Crisis Act of 2015 (H.R.2646) would reform the federal government’s wasteful and inefficient approach to mental illness. It would improve the nation’s mental health delivery system, making it easier for family members to help a loved one with mental illness without having to rely on the involuntary commitment process. The bill would force accountability and coordination among federal agencies that deal with mental health. It would provide funding to support evidence-based programs such as the jail diversion program that our organization, AltaPointe Health Systems, operates. The bill would require additional psychiatric beds, increase Telehealth psychiatry and make sure pediatricians are trained to know when and how to consult with child psychiatrists.

The Mental Health Reform Act of 2015 (S.1945) would address a lack of resources, enhance coordination, and develop meaningful solutions to improve outcomes for families dealing with mental illness. It would also encourage the integration of physical and mental health through grants, creating the position of Assistant Secretary for Mental Health and Substance Use to oversee grants and promote best practices; establish an Interagency Serious Mental Illness Coordinating Committee and a new National Mental Health Policy Laboratory; reauthorize successful research; strengthen transparency and enforcement of mental health parity; and improve mental health services within Medicare and Medicaid.

Improving Access to Emergency Psychiatric Care Act (S.599) passed the Senate on Sept. 29 and is now on the floor of the House for consideration. This bill would amend the Patient Protection and Affordable Care Act to revise the length of the emergency psychiatric demonstration project under Medicaid that is currently limited to three years. AltaPointe’s EastPointe Hospital in Daphne, Ala., participated in the original demonstration project for 2.5 years until it ended unexpectedly this summer. If the House passes the bill, participation in the demonstration project could be extended through FY2016.

If there ever has been a time to contact your senator or representative about a burning issue, that time is now. Doing so may help stem the tide of the horrendous crimes so often attributed to people with mental illness.

Tuerk Schlesinger is CEO of AltaPointe Health Systems, which serves Mobile, Baldwin and Washington counties. Email him at tuerk@altapointe.org.